tbuckley/cabot-search huggingface dataset:
Modernizing the United States’ Public Health Infrastructure: A Position Paper From the American College of Physicians
Authors: Ryan Crowley, Suja Mathew, David Hilden, Suja Mathew, David Hilden, Micah Beachy, William Curry, Matthew Hollon, Cynthia A. Jumper, Pranav Mellacheruvu, Marianne C. Parshley, Ankita Sagar, Jamar Slocum, Michael Tan, Vanessa Van Doren, Elham A. Yousef
Journal: Annals of Internal Medicine (2023)

The United States' public health sector plays a crucial role in preventing illness and promoting health. Public health drove massive gains in life expectancy during the 20th century by supporting vaccination campaigns, promoting motor vehicle safety, and preventing and treating tobacco use. However, public health is underfunded and underappreciated, forcing the field to do more with fewer resources. In this position paper, the American College of Physicians (ACP) updates its 2012 policy recommendations on strengthening the nation's public health infrastructure. ACP calls for effective coordination of public health activities, robust and stable year-to-year funding of public health services, a renewed and well-supported public health workforce, action to address health-related dis- and misinformation, modernized public health data systems, and greater coordination between public health and medical sectors.
Moving Naloxone Over the Counter Is Necessary but Not Sufficient
Authors: John C. Messinger, Leo Beletsky, Aaron S. Kesselheim, Rachel E. Barenie
Journal: Annals of Internal Medicine (2023)

Naloxone is an opioid antagonist that is available in numerous formulations and can be easily administered to avert death from opioid overdose. Amid a historic overdose crisis in the United States, naloxone has a crucial role in stemming the loss of life. However, it remains largely inaccessible to the public. Recently, the U.S. Food and Drug Administration announced the approval of the first over-the-counter formulation of naloxone. Although this historic change provides an important opportunity to increase distribution of naloxone, we must take careful steps during this transition so that it does not paradoxically threaten overall access to this life-saving medication. Specifically, we must ensure that a larger supply of naloxone will meet the newly increased demand at a sustainable price for consumers who are most in need. We must also continue to prioritize comprehensive methods of distribution, such as overdose education and naloxone distribution programs, that serve as important tools to reach the most vulnerable populations. In addition, simultaneous investment in harm-reduction strategies, such as supervised consumption spaces, is critical to ensure that naloxone is available in settings where its life-saving potential can be most fully realized.
Letter to the Editor: Adjuvant gemcitabine plus cisplatin versus capecitabine in node-positive extrahepatic cholangiocarcinoma: The STAMP randomized trial
Authors: Ya-Fei Hu, Han-Fei Gu, Yan-Wen Jin, Fu-Yu Li
Journal: Hepatology (2023)

1Department of Biliary Surgery, West China Hospital, Sichuan University, Chengdu 610041, China 2Department of Biliary Disease Research Center, West China Hospital of Sichuan University, Chengdu, China Foundation item Supported by 1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University (ZYJC21046); 1.3.5 project for disciplines of excellence-Clinical Research Incubation Project, West China Hospital, Sichuan University (2021HXFH001); Natural Science Foundation of Sichuan Province (2022NSFSC0806); National Natural Science Foundation of China for Young Scientists Fund (82203650, 82203782), Sichuan Science and Technology Program (2021YJ0132, 2021YFS0100); The fellowship of China Postdoctoral Science Foundation (2021M692277); Sichuan University-Zigong School-local Cooperation project (2021CDZG-23); Sichuan University-Sui Lin School-local Cooperation project (2022CDSN-18); Science and Technology project of the Health planning committee of Sichuan (21PJ046); Post-Doctor Research Project, West China Hospital, Sichuan University (2020HXBH127). Correspondence Fu-Yu Li, Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China. Add: No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, P.R. China. Email: [email protected]
Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Systemic Cancer Therapy: ASCO Guideline Update
Authors: William Dale, Heidi D. Klepin, Grant R. Williams, Shabbir M.H. Alibhai, Cristiane Bergerot, Karlynn Brintzenhofeszoc, Judith O. Hopkins, Minaxi P. Jhawer, Vani Katheria, Kah Poh Loh, Lisa M. Lowenstein, June M. McKoy, Vanita Noronha, Tanyanika Phillips, Ashley E. Rosko, Tracy Ruegg, Melody K. Schiaffino, John F. Simmons, Ishwaria Subbiah, William P. Tew, Tracy L. Webb, Mary Whitehead, Mark R. Somerfield, Supriya G. Mohile
Journal: Journal of Clinical Oncology (2023)

To update the ASCO guideline (2018) on the practical assessment and management of age-associated vulnerabilities in older patients undergoing systemic cancer therapy.
Reply: What is the actual role of decompensated cirrhosis in the breakthrough SARS-CoV-2 infection?
Authors: Jin Ge, Jean C. Digitale, Mark J. Pletcher, Jennifer C. Lai
Journal: Hepatology (2023)

Ge, Jin; Digitale, Jean C.; Pletcher, Mark J.; Lai, Jennifer C.; for the N3C Consortium Collaborators Chute, Christopher G.; Harper, Jeremy R.; Gabriel, Davera; Haendel, Melissa A.; Pfaff, Emily; Leese, Peter Author Information
Addressing Viral Medical Rumors and False or Misleading Information
Authors: Hussain S. Lalani, Renée DiResta, Richard J. Baron, David Scales
Journal: Annals of Internal Medicine (2023)

The rapid spread of medical rumors and false or misleading information on social media during times of uncertainty is a vexing challenge that threatens public health. Understanding the information ecosystem, social media networks, and the scope of incentives that drive users and social media platforms can provide critical insights for strong coordination between stakeholders and funders to address this challenge. The COVID-19 pandemic created an opportunity to demonstrate the role of media monitoring and counter-messaging efforts in responding to dangerous medical rumors, misinformation, and disinformation. It also highlighted the challenges. The efforts of ThisIsOurShot and VacunateYa to spread accurate health information about COVID-19 and COVID-19 vaccines are described and lessons learned are discussed. These lessons include the need for substantial financial investments at the local and national levels to sustain and scale these types of programs. Examples in other fields that offer a path forward include Information Sharing and Analysis Centers and Public Health Emergency Operations Centers. Understanding the scale and scope of what it takes to address viral medical rumors, misinformation, and disinformation in a networked information environment should inspire elected leaders to consider policy and regulatory reforms. Our transformed information ecosystem requires new public health infrastructure to address information that threatens personal safety and population health.
Correction: Fortified balanced energy–protein supplementation during pregnancy and lactation and infant growth in rural Burkina Faso: A 2 × 2 factorial individually randomized controlled trial
Authors: Alemayehu Argaw, Brenda de Kok, Laeticia Celine Toe, Giles Hanley-Cook, Trenton Dailey-Chwalibóg, Moctar Ouédraogo, Anderson Compaoré, Katrien Vanslambrouck, Rasmané Ganaba, Patrick Kolsteren, Carl Lachat, Lieven Huybregts
Journal: PLoS Medicine (2023)

[This corrects the article DOI: 10.1371/journal.pmed.1004186.].
Diagnosis and Management of Cardiovascular Risk in Individuals With Spinal Cord Injury: A Narrative Review
Authors: Tara Lagu, Samantha L. Schroth, Carol Haywood, Allen Heinemann, Allison Kessler, Leslie Morse, Sadiya S. Khan, Kiarri N. Kershaw, Mark S. Nash
Journal: Circulation (2023)

More than 16 000 Americans experience spinal cord injury (SCI), resulting in chronic disability and other secondary sequelae, each year. Improvements in acute medical management have increased life expectancy. Cardiovascular disease is a leading cause of death in this population, and seems to occur earlier in individuals with SCI compared with the general population. People with SCI experience a high burden of traditional cardiovascular disease risk factors, including dyslipidemia and diabetes, and demonstrate anatomic, metabolic, and physiologic changes alongside stark reductions in physical activity after injury. They also experience multiple, complex barriers to care relating to disability and, in many cases, compounding effects of intersecting racial and socioeconomic health inequities. Given this combination of risk factors, some investigators have proposed that people with SCI are at increased risk for cardiovascular disease, beyond that associated with traditional risk factors, and SCI could be considered a risk-enhancing factor, analogous to other risk-enhancing factors defined by the 2019 American Heart Association/American College of Cardiology Primary Prevention Guidelines. However, more research is needed in this population to clarify the role of traditional risk factors, novel risk factors, health care access, social determinants of health, and intersectionality of disability, race, and socioeconomic status. There is an urgent need for primary care physicians and cardiologists to have awareness of the importance of timely diagnosis and management of cardiac risk factors for people with SCI.
Race-Based Differences in ST-Segment–Elevation Myocardial Infarction Process Metrics and Mortality From 2015 Through 2021: An Analysis of 178 062 Patients From the American Heart Association Get With The Guidelines–Coronary Artery Disease Registry
Authors: Asishana Osho, Marcelo F. Fernandes, Ram Poudel, James de Lemos, Haoyun Hong, Juan Zhao, Shen Li, Kathie Thomas, Daniel S. Kikuchi, Jessica Zegre-Hemsey, Nasrien Ibrahim, Nilay S. Shah, Lori Hollowell, Jacqueline Tamis-Holland, Christopher B. Granger, Mauricio Cohen, Timothy Henry, Alice K. Jacobs, James G. Jollis, Clyde W. Yancy, Abhinav Goyal
Journal: Circulation (2023)

BACKGROUND: Systems of care have been developed across the United States to standardize care processes and improve outcomes in patients with ST-segment–elevation myocardial infarction (STEMI). The effect of contemporary STEMI systems of care on racial and ethnic disparities in achievement of time-to-treatment goals and mortality in STEMI is uncertain. METHODS: We analyzed 178 062 patients with STEMI (52 293 women and 125 769 men) enrolled in the American Heart Association Get With The Guidelines–Coronary Artery Disease registry between January 1, 2015, and December 31, 2021. Patients were stratified into and outcomes compared among 3 racial and ethnic groups: non-Hispanic White, Hispanic White, and Black. The primary outcomes were the proportions of patients achieving the following STEMI process metrics: prehospital ECG obtained by emergency medical services; hospital arrival to ECG obtained within 10 minutes for patients not transported by emergency medical services; arrival-to–percutaneous coronary intervention time within 90 minutes; and first medical contact–to-device time within 90 minutes. A secondary outcome was in-hospital mortality. Analyses were performed separately in women and men, and all outcomes were adjusted for age, comorbidities, acuity of presentation, insurance status, and socioeconomic status measured by social vulnerability index based on patients’ county of residence. RESULTS: Compared with non-Hispanic White patients with STEMI, Hispanic White patients and Black patients had lower odds of receiving a prehospital ECG and achieving targets for door-to-ECG, door-to-device, and first medical contact–to-device times. These racial disparities in treatment goals were observed in both women and men, and persisted in most cases after multivariable adjustment. Compared with non-Hispanic White women, Hispanic White women had higher adjusted in-hospital mortality (odds ratio, 1.39 [95% CI, 1.12–1.72]), whereas Black women did not (odds ratio, 0.88 [95% CI, 0.74–1.03]). Compared with non-Hispanic White men, adjusted in-hospital mortality was similar in Hispanic White men (odds ratio, 0.99 [95% CI, 0.82–1.18]) and Black men (odds ratio, 0.96 [95% CI, 0.85–1.09]). CONCLUSIONS: Race- or ethnicity-based disparities persist in STEMI process metrics in both women and men, and mortality differences are observed in Hispanic White compared with non-Hispanic White women. Further research is essential to evolve systems of care to mitigate racial differences in STEMI outcomes.
Crosstalk Between the Neuroendocrine System and Bone Homeostasis
Authors: Yuhu Zhao, Xiaole Peng, Qing Wang, Zhiyu Zhang, Liangliang Wang, Yaozeng Xu, Huilin Yang, Jiaxiang Bai, Dechun Geng
Journal: Endocrine Reviews (2023)

Abstract The homeostasis of bone microenvironment is the foundation of bone health and comprises 2 concerted events: bone formation by osteoblasts and bone resorption by osteoclasts. In the early 21st century, leptin, an adipocytes-derived hormone, was found to affect bone homeostasis through hypothalamic relay and the sympathetic nervous system, involving neurotransmitters like serotonin and norepinephrine. This discovery has provided a new perspective regarding the synergistic effects of endocrine and nervous systems on skeletal homeostasis. Since then, more studies have been conducted, gradually uncovering the complex neuroendocrine regulation underlying bone homeostasis. Intriguingly, bone is also considered as an endocrine organ that can produce regulatory factors that in turn exert effects on neuroendocrine activities. After decades of exploration into bone regulation mechanisms, separate bioactive factors have been extensively investigated, whereas few studies have systematically shown a global view of bone homeostasis regulation. Therefore, we summarized the previously studied regulatory patterns from the nervous system and endocrine system to bone. This review will provide readers with a panoramic view of the intimate relationship between the neuroendocrine system and bone, compensating for the current understanding of the regulation patterns of bone homeostasis, and probably developing new therapeutic strategies for its related disorders.
Arrhythmia and Survival Outcomes Among Black Patients and White Patients With a Primary Prevention Defibrillator
Authors: Arwa Younis, Sanah Ali, Eileen Hsich, Ido Goldenberg, Scott McNitt, Bronislava Polonsky, Mehmet K. Aktas, Valentina Kutyifa, Oussama M. Wazni, Wojciech Zareba, Ilan Goldenberg
Journal: Circulation (2023)

Black Americans have a higher risk of nonischemic cardiomyopathy (NICM) than White Americans. We aimed to evaluate differences in the risk of tachyarrhythmias among patients with an implantable cardioverter-defibrillator (ICD).The study population comprised 3895 ICD recipients in the United States enrolled in primary prevention ICD trials. Outcome measures included ventricular tachyarrhythmia (VTA), atrial tachyarrhythmia (ATA), ICD therapies, VTA burden (using Andersen-Gill recurrent event analysis), death, and the predicted benefit of the ICD. All events were adjudicated blindly. Outcomes were compared between self-reported Black patients versus White patients with cardiomyopathy (ischemic and NICM).Black patients were more likely to be female (35% versus 22%) and younger (57±12 versus 62±12 years) with a higher frequency of comorbidities. In NICM, Black patients had a higher rate of first VTA, fast VTA, ATA, and appropriate and inappropriate ICD therapy (VTA ≥170 bpm, 32% versus 20%; VTA ≥200 bpm, 22% versus 14%; ATA, 25% versus 12%; appropriate therapy, 30% versus 20%; and inappropriate therapy, 25% versus 11%; P<0.001 for all). Multivariable analysis showed that Black patients with NICM experienced a higher risk of all types of arrhythmia or ICD therapy (VTA ≥170 bpm, hazard ratio [HR] 1.71; VTA ≥200 bpm, HR 1.58; ATA, HR 1.87; appropriate therapy, HR 1.62; inappropriate therapy, HR 1.86; P≤0.01 for all), higher burden of tachyarrhythmias or therapies (VTA, HR 1.84; appropriate therapy, HR 1.84; P<0.001 for both), and a higher risk of death (HR 1.92; P=0.014). In contrast, in ischemic cardiomyopathy, the risk of all types of tachyarrhythmia, ICD therapy, or death was similar between Black patients and White patients. Both Black patients and White patients derived a significant and similar benefit from ICD implantation.Among patients with NICM with an ICD for primary prevention, Black patients compared with White patients had a high risk and burden of VTA, ATA, and ICD therapies with a lower survival rate. Nevertheless, the overall benefit of the ICD was maintained and was similar to that of White patients.
Associations Between Maternal Sociodemographics and Hospital Mortality in Newborns With Prenatally Diagnosed Hypoplastic Left Heart Syndrome
Authors: Keila N. Lopez, Shaine A. Morris, Anita Krishnan, Marni B. Jacobs, Aarti H. Bhat, Anjali Chelliah, Joanne S. Chiu, Bettina F. Cuneo, Grace Freire, Lisa K. Hornberger, Lisa Howley, Nazia Husain, Catherine Ikemba, Ann Kavanaugh-McHugh, Shelby Kutty, Caroline Lee, Angela McBrien, Erik C. Michelfelder, Nelangi M. Pinto, Rachel Schwartz, Kenan W.D. Stern, Carolyn Taylor, Varsha Thakur, Wayne Tworetzky, Carol Wittlieb-Weber, Kris Woldu, Mary T. Donofrio, Shabnam Peyvandi, Mary Craft, Heather Gramse, Anita Moon-Grady, Wes Lee, Dawn Park, Alysia Wiener
Journal: Circulation (2023)

ace and ethnicity, socioeconomic status (SES), and geography have been associated with differential outcomes in congenital heart disease death.In patients with hypoplastic left heart syndrome (HLHS), lower SES has been associated with increased complications and lower 1-year survival. 1o previous study has examined how sociodemographics affect neonatal death among prenatally diagnosed patients with HLHS.The study goal was to investigate infants with a prenatal diagnosis of HLHS to understand associations between maternal sociodemographics and patient characteristics and hospital discharge mortality.The data that support the findings of this study are available from the corresponding author on reasonable request.
Historical Redlining, Socioeconomic Distress, and Risk of Heart Failure Among Medicare Beneficiaries
Authors: Amgad Mentias, Mahasin S. Mujahid, Andrew Sumarsono, Robert K. Nelson, Justin M. Madron, Tiffany M. Powell-Wiley, Utibe R. Essien, Neil Keshvani, Saket Girotra, Alanna A. Morris, Mario Sims, Quinn Capers, Clyde Yancy, Milind Y. Desai, Venu Menon, Shreya Rao, Ambarish Pandey
Journal: Circulation (2023)

The association of historical redlining policies, a marker of structural racism, with contemporary heart failure (HF) risk among White and Black individuals is not well established.
Does the Primacy of the Fistula Still Prevail in an Aging Hemodialysis Population?
Authors: Karl A. Nath
Journal: Journal of the American Society of Nephrology (2023)

Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota Correspondence: Dr. Karl A. Nath, Division of Nephrology and Hypertension, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. Email: [email protected] Published online ahead of print. Publication date available at www.jasn.org. See related article, "Effects of a More Selective Arteriovenous Fistula Strategy on Vascular Access Outcomes," on pages 1589–1600.
A loop-assisted inversion technique for easy removal of a gastric stromal tumor in the fundus
Authors: Zhang Tao, Long Chen, Jie Liu, Yi Ming Peng, Feng Ying Lin, Liang Sun, Jian Chen
Journal: Endoscopy (2023)

A 54-year-old woman presented with a stromal tumor (approximately 2 × 1 cm) in the gastric fundus ([Fig. 1] and [Fig. 2 a]). After it had been marked and submucosal injection performed under endoscopic guidance, an electrosurgical knife was used to make a circular incision ([Video 1]). This was challenging because of the difficult approach and the high risk of perforation, with an IT knife being used to make the incision ([Fig. 2 b]). A clip-anchored loop was fixed 1 cm from the incised wound ([Fig. 2 c]). A snare was then used to trap the incised mucosa and lift it, with the loop ring being slowly tightened ([Fig. 2 d]). After the snare was released, inversion of the tumor was observed ([Fig. 2 e] and [Fig. 3]). Next, an electrosurgical knife was used to cut and expose the tumor margins, and a snare was then used to trap the tumor base and perform electrosurgical excision ([Fig. 2 f]). After the excision, the clean inverted wound was sutured using clips ([Fig. 2 g]). Finally, the loop was released. The resected specimen was an intact tumor measuring approximately 2 × 1 cm ([Fig. 4]). At follow-up 1 month later, a flat wound with a residual loop was observed ([Fig. 5]).
The age profile of respiratory syncytial virus burden in preschool children of low- and middle-income countries: A semi-parametric, meta-regression approach
Authors: Marina Antillón, Xiao Li, Lander Willem, Joke Bilcke, Mark Jit, Philippe Beutels
Journal: PLoS Medicine (2023)

Respiratory syncytial virus (RSV) infections are among the primary causes of death for children under 5 years of age worldwide. A notable challenge with many of the upcoming prophylactic interventions against RSV is their short duration of protection, making the age profile of key interest to the design of prevention strategies.
Lung Function Trajectories and Associated Mortality among Adults with and without Airway Obstruction
Authors: Helena Backman, Anders Blomberg, Anders Lundquist, Viktor Strandkvist, Sami Sawalha, Ulf Nilsson, Jonas Eriksson-Ström, Linnea Hedman, Caroline Stridsman, Eva Rönmark, Anne Lindberg
Journal: American Journal of Respiratory and Critical Care Medicine (2023)

Rationale: Spirometry is essential for diagnosis and assessment of prognosis in patients with chronic obstructive pulmonary disease (COPD).Objectives: To identify FEV 1 trajectories and their determinants on the basis of annual spirometry measurements among individuals with and without airway obstruction (AO) and to assess mortality in relation to trajectories.Methods: From 2002 through 2004, individuals with AO (FEV 1 / VC , 0.70, n = 993) and age-and sex-matched nonobstructive (NO) referents were recruited from population-based cohorts.Annual spirometry until 2014 was used in joint-survival latentclass mixed models to identify lung function trajectories.Mortality data were collected during 15 years of follow-up.Measurements and Main Results: Three trajectories were identified among the subjects with AO and two among the NO referents.Trajectory membership was driven by baseline FEV 1 % predicted (FEV 1 %pred) in both groups and also by pack-years in subjects with AO and current smoking in NO referents.Longitudinal FEV 1 %pred depended on baseline FEV 1 %pred, pack-years, and obesity.The trajectories were distributed as follows: among individuals with AO, 79.6% in AO trajectory 1 (FEV 1 high with normal decline), 12.8% in AO trajectory 2 (FEV 1 high with rapid decline), and 7.7% in AO trajectory 3 (FEV 1 low with normal decline) (mean, 27, 72, and 26 ml/yr, respectively) and, among NO referents, 96.7% in NO trajectory 1 (FEV 1 high with normal decline) and 3.3% in NO trajectory 2 (FEV 1 high with rapid decline) (mean, 34 and 173 ml/yr, respectively).Hazard for death was increased for AO trajectories 2 (hazard ratio [HR], 1.56) and 3 (HR, 3.45) versus AO trajectory 1 and for NO trajectory 2 (HR, 2.99) versus NO trajectory 1.Conclusions: Three different FEV 1 trajectories were identified among subjects with AO and two among NO referents, with different outcomes in terms of FEV 1 decline and mortality.The FEV 1 trajectories among subjects with AO and the relationship between low FVC and trajectory outcome are of particular clinical interest.